Somehow I have left my Spiriva (Tiotropium Bromide) inhaler in the UK when coming on holiday to the US. It's very expensive to go to a doctor here and with medication on top is likely to cost nearly £200. I have medical insurance but the excess is £100. I am here for another eight days and have my other two inhalers with me and feel fine. Does anyone know how important it is for me to get a replacement or whether it will be okay to wait until I return to the UK. I would really appreciate some advice.

You will feel shorter of breath without it but to what degree I don't know. Can you call the BLF? I have a bad reaction to most inhalers and now manage without (stage 4 COPD). I would try without and see how you go. I don't think it is an emergency but I am not you.

'. . . Trough FEV1 increased after 1 week of daily administration [of tiotropium] and remained consistently greater than that for placebo through the treatment period. Two to three weeks after cessation of therapy, the FEV1 response for all doses gradually returned to baseline; however, it never fell below baseline, so there was no evidence of rebound deterioration. . . .'

Ive been on Spiriva in the past and had to stop after a couple of months due to side effects. Stopping it made no difference to me whatsoever and i didn't have any kind of replacement. But everyone's different and it might depend on how much it helped you when you first started taking it; whether there is an asthma component to your copd - there are many different things to take into consideration.

One thing that does occur to me is that you might be fine or just a bit more breathless without your Spiriva, but if you caught an infection, and people often do after flying, you would probably want all the meds you normally take there with you (as well as a rescue pack etc which i hope you've got).

Thank you all so much for your advice and support. I've at last got through to BLF and spoke to a respiratory nurse. She advised me to get a replacement which I plan to do. Thanks again and enjoy your day

Leaving my Spiriva at home been a salutary lesson. It sort me 99 dollars to get a prescription and 375 dollars to replace them. Nearly 500 dollars in total!!!!! The lesson from this is pack your meds carefully if you are going away.

Hi, I have left my inhalers at home when going on holiday in Europe. The chemist can issue any meds I need by looking at my prescription list. I don't know about USA but it is surely worth asking the pharmacist. Contacting the British Embassy seems like a good idea if the pharmacy cannot help. Good luck Maximonkey